[1]赵东肖,宋良月.蛛网膜下腔出血术后并发脑膜炎患者脑脊液CXCL13，IP-10水平表达及临床意义[J].现代检验医学杂志,2021,36(06):101-105.[doi:10.3969/j.issn.1671-7414.2021.06.021]
　ZHAO Dong-xiao,SONG liang-yue.Expression and Clinical Significance of CXCL13 and IP-10 Levels in Cerebrospinal Fluid of Patients with Meningitis after Subarachnoid Hemorrhage[J].Journal of Modern Laboratory Medicine,2021,36(06):101-105.[doi:10.3969/j.issn.1671-7414.2021.06.021]
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蛛网膜下腔出血术后并发脑膜炎患者脑脊液CXCL13，IP-10水平表达及临床意义()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年06期
页码:
101-105
栏目:
论　著
出版日期:
2021-12-15

文章信息/Info

Title:
Expression and Clinical Significance of CXCL13 and IP-10 Levels in Cerebrospinal Fluid of Patients with Meningitis after Subarachnoid Hemorrhage
文章编号:
1671-7414（2021）05-101-05
作者:
赵东肖; 宋良月
（沈阳市第四人民医院老年医学中心，辽宁沈阳 110000）
Author(s):
ZHAO Dong-xiao;  SONG liang-yue
（Geriatric Center , the Fourth People’s Hospital of Shenyang City, Shenyang 110000, China）
关键词:
蛛网膜下腔出血; 脑膜炎; 趋化因子CXC配体13; γ-干扰素诱导蛋白10
分类号:
R743.35；R392.11
DOI:
10.3969/j.issn.1671-7414.2021.06.021
文献标志码:
A
摘要:
目的　探究蛛网膜下腔出血（subarachnoid hemorrhage, SAH）术后脑膜炎患者脑脊液趋化因子CXC配体13(chemokine CXC ligand 13, CXCL13)，γ-干扰素诱导蛋白10(IFN-γ inducible protein 10, IP-10)水平及其临床意义。方法　选取2015年12月~2019年12月沈阳市第四人民医院诊治的134例SAH患者进行研究，依据患者是否并发脑膜炎分为未并发脑膜炎组（n=67）和并发脑膜炎组（n=67）。比较两组一般资料；以酶联免疫吸附法（ELISA）检测所有受试者脑脊液CXCL13和IP-10水平；以Pearson法分析SAH术后并发脑膜炎患者脑脊液CXCL13水平与IP-10的相关性；采用受试者特征工作曲线（ROC）评价脑脊液CXCL13和IP-10水平对SAH术后并发脑膜炎的诊断价值；Logistic回归分析SAH患者术后并发脑膜炎的影响因素。结果　并发脑膜炎组脑脊液白细胞计数[575.96（72.84, 994.64）×106/L vs 66.23（15.03,142.78）×106/L]、蛋白含量（1.98±0.59g/L vs 1.32±0.42 g/L) 、乳酸含量（6.26±1.75mmol/L vs 3.48±1.06mmol/L)、CXCL13（485.73±171.90pg/ml vs 224.92±84.05pg/ml)，IP-10（587.49±182.45ng/L vs 275.08±95.33 ng/L)水平均显著高于未并发脑膜炎组，差异均有统计学意义（Z/t=32.379，7.459，11.122，11.157和12.422，均P<0.001）；SAH术后并发脑膜炎患者脑脊液CXCL13水平与IP-10呈正相关（r=0.471, P<0.05）；脑脊液CXCL13和IP-10水平诊断SAH术后并发脑膜炎的曲线下面积（AUC）分别为0.855和0.862，对应截断值分别为327.84 pg/ml，451.43 ng/L，此时对应灵敏度分别为80.6%和74.6%，特异度分别为83.6%和89.6%；两者联合诊断SAH术后并发脑膜炎的AUC为0.914，相应灵敏度、特异度分别为89.6%和88.1%；白细胞计数、CXCL13，IP-10是影响SAH患者术后并发脑膜炎的危险因素（95%CI=1.199~2.752，1.166~2.763和1.251~2.999，均P＜0.05）。结论　CXCL13，IP-10在SAH术后并发脑膜炎患者脑脊液中水平显著上升，两者可能相互影响，进而共同影响术后并发脑膜炎进程，两者联合有助于筛查术后并发脑膜炎患者。
Abstract:
Objective　To investigate the levels of chemokine CXC ligand 13 (CXCL13) and IFN-γ inducible protein 10 (IP-10) in cerebrospinal fluid of patients with meningitis after subarachnoid hemorrhage (SAH) and their clinical significance. Methods　A total of 134 SAH patients who were diagnosed and treated in the Fourth People’s Hospital of Shenyang City, from December 2015 to December 2019 were selected for study. According to whether the patients were complicated with meningitis, they were divided into non complicated meningitis group (n = 67) and complicated meningitis group (n = 67). The general data of the two groups were compared. The levels of CXCL13 and IP-10 in cerebrospinal fluid were detected by enzyme-linked immunosorbent assay (ELISA). The correlation between CXCL13 and IP-10 in cerebrospinal fluid of patients with meningitis after SAH was analyzed by Pearson method. The diagnostic values of CXCL13 and IP-10 in cerebrospinal fluid for meningitis after SAH were evaluated by ROC. In addition, Logistic regression was used to analyze the influencing factors of postoperative meningitis in SAH patients. Results　Cerebrospinal fluid white blood cell count [575.96 (72.84, 994.64)×106/L vs 66.23 (15.03,142.78)×106/L], protein content (1.98±0.59g/L vs 1.32±0.42 g/L), lactic acid content (6.26±1.75mmol/L vs 3.48±1.06 mmol/L), CXCL13(485.73±171.90 pg/ml vs 224.92±84.05 pg/ml), IP-10(587.49±182.45 ng/L vs 275.08±95.33 ng/L) level in the meningitis group was significantly higher than that of the group without meningitis, and the difference was statistically significant (Z/t=32.379, 7.459, 11.122, 11.157和12.422, all P<0.001), and there was a positive correlation between the level of CXCL13 in cerebrospinal fluid and IP-10 in patients with meningitis after SAH (r=0.471, P<0.05). The area under curve (AUC) of the levels of CXCL13 and IP-10 in cerebrospinal fluid in the diagnosis of meningitis after SAH was 0.855 and 0.862, respectively and the corresponding cutoff value was 327.84 pg/ml and 451.43 ng/l, respectively. At this time, the corresponding sensitivity was 80.6% and 74.6%, and the specificity was 83.6% and 89.6%, respectively. The AUC of the combination was 0.914, and the sensitivity and specificity were 89.6% and 88.1%, respectively. In addition, white blood cell count, CXCL13 and IP-10 were the risk factors of postoperative meningitis in SAH patients (95%CI=1.199~2.752, 1.166~2.763 and 1.251~2.999, all P＜0.05). Conclusion　The levels of CXCL13 and IP-10 in cerebrospinal fluid of patients with meningitis after SAH are significantly increased, which may influence each other, and then affect the process of meningitis after SAH. Therefore, the combination of the two is helpful to screen patients with meningitis after SAH.

参考文献/References:

[1] HUGHES G, GREEN C A, STREET D, et al. Casereport: subarachnoid hemorrhage and eosinophilicmeningitis due to disseminated fascioliasis[J]. TheAmerican Journal of Tropical Medicine and Hygiene,2020, 102(3): 574-577.
[2] 张钦林，罗霄鹏，包正军，等．联合检测CRP,IL-6,Procalcitonin 水平在成人脑膜炎诊断中的应用价值[J]. 卒中与神经疾病, 2019, 26(5):573-578.．ZHANG Qinlin, LUO Xiaopeng, BAO Zhengjun, etal. The value of combined examination of CRP,IL6,Procalcitonin levels in the diagnosis of adultmeningitis [J]. Stroke and Nervous Diseases, 2019,26(5):573-578.
[3] BOSKABADI H, HEIDARI E, ZAKERIHAMIDI M.Etiology, clinical findings and laboratory parametersin neonates with acute bacterial meningitis[J]. IranianJournal of Microbiology, 2020, 12(2): 89-97.
[4] 王聪慧, 张伟, 刘建博, 等. 血清趋化因子CXCL13水平与支气管哮喘的相关性研究[J]. 安徽医学,2019, 40(7):725-728.WANG Conghui, ZHANG Wei, LIU Jianbo, et al.Correlation of serum chemokine CXCL13 levels withbronchial asthma [J]. Anhui Medical Journal, 2019,40(7):725-728.
[5] 周薇，唐凌雯，熊毅．多发性硬化症患者外周血及脑脊液中Tfh,CXCL13 水平变化及其临床意义[J]．临床和实验医学杂志, 2018, 17(18):1977-1980.ZHOU Wei, TANG Lingwen, XIONG Yi. Changesof Tfh ,CXCL13 levels in peripheral blood andcerebrospinal fluid of patients with multiple sclerosisand their clinical signifi-cance [J]. Journal of Clinicaland Experimental Medicine, 2018, 17(18):1977-1980.
[6] RAUCH J, ZAMMARCHI L, CORTI G, et al. Serumcytokine and chemokine changes during Toscana virusmeningitis[J]. Medical Microbiology and Immunology,2019, 208(6): 727-730.
[7] 范存刚，孙澎，张庆俊．2012 年AHA/ASA《动脉瘤性蛛网膜下腔出血的诊疗指南》解读[J]．中华神经医学杂志, 2013, 12(6):541-544.FAN Cungang, SUN Peng, ZHANG Qingjun.Diagnosis and treatment guidelines of aneurysmalsubarachnoid hemorrhage issued by American HeartAssociation and American stroke association in2012: a brief interpretation [J]. Chinese Journal ofNeuromedicine, 2013, 12(6):541-544.
[8] HORAN T C, ANDRUS M, DUDECK M A. CDC/NHSN surveillance definition of health care-associatedinfection and criteria for specific types of infections inthe acute care setting[J]. American Journal of InfectionControl, 2008, 36(5): 309-332.
[9] HOOGMOED J, VAN DE BEEK D, COERT B A, et al.Clinical and laboratory characteristics for the diagnosisof bacterial ventriculitis after aneurysmal subarachnoidhemorrhage[J]. Neurocritical Care, 2017, 26(3): 362-370.
[10] LA RUSSA R, MAIESE A, DI FAZIO N, et al. Posttraumaticmeningitis is a diagnostic challenging time: asystematic review focusing on clinical and pathologicalfeatures[J]. International Journal of Molecular Sciences,2020, 21(11): 4148.
[11] MARKOWICZ M, SCH?TTA A M, KUNDI M, etal. CXCL13 concentrations in cerebrospinal fluidof patients with Lyme neuroborreliosis and otherneurological disorders determined by Luminex andELISA[J]. Ticks and Tick-borne Diseases, 2018, 9(5):1137-1142.
[12] PILZ G, WIPFLER P, OTTO F, et al. Cerebrospinalfluid CXLC13 indicates disease course inneuroinfection: an observational study[J]. Journal ofNeuroinflammation, 2019, 16(1): 13.
[13] LEPENNETIER G, HRACSKO Z, UNGER M, et al.Cytokine and immune cell profiling in the cerebrospinalfluid of patients with neuro-inflammatory diseases[J].Journal of Neuroinflammation, 2019, 16(1): 219.
[14] 景灵, 鲍红光, 曾令清, 等.CXCL13 在小鼠脓毒症相关性脑病中的作用[J]. 中华麻醉学杂志,2018, 38(11):1388-1392.JING Ling, BAO Hongguang, ZENG Lingqing, etal. Role of C-X-C motif chemokine 13 in sepsisassociatedencephalopathy in mice [J]. Chinese Journalof Anesthesiology, 2018, 38(11):1388-1392.
[15] BARSTAD B, TVEITNES D, NORAAS S, et al.Cerebrospinal fluid B-lymphocyte chemoattractantCXCL13 in the diagnosis of acute lyme neuroborreliosisin children[J]. The Pediatric Infectious Disease Journal,2017, 36(12): e286-e292.
[16] LI Ruohan, MA Liming, HUANG Hao, et al. Alteredexpression of CXCL13 and CXCR5 in intractabletemporal lobe epilepsy patients and pilocarpine-inducedepileptic rats[J]. Neurochemical Research, 2017, 42(2):526-540.
[17] NIWA A, OSUKA K, NAKURA T, et al. Interleukin-6,MCP-1, IP-10, and MIG are sequentially expressed incerebrospinal fluid after subarachnoid hemorrhage[J].Journal of Neuroinflammation, 2016, 13(1): 217.
[18] 钟峰, 方咏梅, 张晶晶, 等. 儿童呼吸道感染患者血清IP-10,MCP-1 水平检测的临床意义[J]. 现代检验医学杂志, 2020, 35(1):53-56.ZHONG Feng, FANG Yongmei, ZHANG Jingjing,et al. Clinical significance of detect serum IP-10 andMCP-1 levels in children with respiratory infection[J].Journal of Modern Laboratory Medicine, 2020,35(1):53-56.
[19] 刘倩, 黄银兰, 薛小卫, 等. 液相芯片技术检测癫痫大鼠海马组织RANTES,MCP-1,IP-10 的表达研究[J].辽宁中医杂志,2018,45(5):1062-1065.LIU Qian, HUANG Yinlan, XUE Xiaowei, et al. Studyon expressions of RANTES, MCP-1 and IP-10 inhippocampus of epileptic rats by liquid chromatography[J]. Liaoning Journal of Traditional Chinese Medicine,2018, 45(5):1062-1065.
[20] QUIST-PAULSEN E, AUKRUST P, KRAN A B, et al.High neopterin and IP-10 levels in cerebrospinal fluidare associated with neurotoxic tryptophan metabolitesin acute central nervous system infections[J]. Journal ofNeuroinflammation, 2018, 15(1): 327.

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备注/Memo

备注/Memo:
基金项目：沈阳市科技计划项目（19-112-4-047）。作者简介：赵东肖（1983-），女，硕士研究生，副主任医师，研究方向：神经内科，E-mail：zdx01230@163.com。
更新日期/Last Update: 1900-01-01